Using palliative sedation to relieve existential suffering is less common in the United States than it is in other Western countries, according to UCLA's Dr. [Thomas] Strouse and other American practitioners. "I am not comfortable with supplying palliative sedation for existential suffering," Dr. Strouse said. "I've never done that and probably wouldn't."

In states where aid-in-dying is legal, terminally ill patients rarely choose between aid-in-dying and palliative sedation, said Anthony Back, co-director of the University of Washington's Cambia Palliative Care Center of Excellence. In Washington, patients with a prognosis of six months to live or less must make two verbal requests to their doctor at least 15 days apart and sign a written form. They also must be healthy enough to take the legal drugs themselves.

"If you are starting the death-with-dignity process, you're not at a point where a doctor would recommend palliative sedation," Dr. Back said. "And with terminal sedation, the patient doesn't have that kind of time and is too sick to take all those meds orally," he said of the aid-in-dying drugs.

But Dr. Back does tell terminally ill patients who don't want or don't qualify for aid-in-dying that, when the time is right and no other treatments alleviate their symptoms, "I would be willing to make sure that you get enough sedation so you won't be awake and miserable." [bold added]

I am just about as dubious about calling aid-in-dying "right to die" as I am about all the "rights" (such as "housing," that are really violations of actual rights, such as property) manufactured mainly by the left. First off, aid-in-dying is an aspect of the right each individual has to his own life. So calling it by that name obscures the real issue. From there, we begin fighting to pass laws -- as if carving out a brand new area of freedom -- when maybe some statutes ought to be repealed first. (This is not to say that we wouldn't need new law (such as that making sure the patient really does want such assistance): We aren't, after all, accustomed to exercising this part of that right within the legal system.)

That said, one product of this myopic focus on death (versus living one's life as one sees fit) might be for proponents of aid-in-dying to be tempted to gloss over this difference to make their cause more palatable to people who have not thought much about the issue. Such a move will rightly lose them credibility among the most thoughtful -- those most vital to the cause. Conversely, opponents might seize on the surface similarity between aid-in-dying and palliative sedation to lull those same people into thinking the issue has already been adequately addressed, which is clearly not the case.

I lost a loved one who required morphine near death many years ago, and I support aid-in-dying; yet I had to think about this distinction. If that thought can cross my mind, I am sure that there will be people on either side of that debate who will attempt to exploit the fact that palliative care can sound a lot like aid-in dying. Those of us who value our lives -- enough to want the option to end them on our own terms if we are unfortunate enough to want it -- should make sure such tactics do not go unnoticed.